Risk Adjustment Coding Specialist

Overview

We are seeking a certified coder with expertise in Risk Adjustment to join our team. The ideal candidate will have prior experience in Risk Adjustment coding and will support both Medicare and Medicaid Risk Adjustment clinical activities.

Base pay range

$24.50 / hr - $27.00 / hr

Responsibilities

• Medicare Risk Adjustment : Identify, collect, assess, monitor, and document ICD-10 diagnosis-based coding information related to CMS Hierarchical Condition Categories (HCC).
• Participate in and support a team-based environment to educate providers on coding compliance and consistency.
• Support the creation, maintenance, and enhancement of clinical documentation accuracy to build a care model focused on quality and health outcomes.
• Leverage clinical, coding, and documentation expertise to improve the overall quality, completeness, and compliance of clinical documentation.
• Alert leadership to trends and irregularities that indicate deviations from coding protocols.
• Conduct chart reviews related to Provider Risk Adjustment Activity and clinical documentation errors, addressing HCC alerts at the Date of Service (DOS).
• Medicaid Risk Adjustment : Support initiatives and interventions for Medicaid Risk Adjustment activities.
• Review, audit, and monitor Community Health Assessments (CHA) completed by nurses and contracted nurses.
• Educate nurses on accurate documentation based on audit outcomes.
• Collaborate with different teams to improve the accuracy and completion of CHA assessments as they pertain to Risk Adjustment.

This role involves working under moderate supervision, and the successful candidate will play a crucial role in enhancing clinical documentation and supporting quality health outcomes.

Qualifications

Job details

J-18808-Ljbffr